Gluvic Z, Lackovic M, Samardzic V, Mitrovic B, Mladenovic V, et al. (2019) Management of Non-Classic Congenital Adrenal Hyperplasia in Pregnant Woman - Non-Referral Center Experience-Case Report. Clin Med Rev Case Rep 6:257.


© 2019 Gluvic Z, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/2378-3656/1410257

Management of Non-Classic Congenital Adrenal Hyperplasia in Pregnant Woman - Non-Referral Center Experience- Case Report

Zoran Gluvic1, Milena Lackovic1, Vladimir Samardzic1, Bojan Mitrovic1, Violeta Mladenovic2, Milan Obradovic3, Danimir Jevremovic4 and Esma R Isenovic3*

1Department of Endocrinology and Diabetes, Zemun Clinical Hospital, University of Belgrade, Serbia

2Clinical Centre Kragujevac, Clinic for Endocrinology, University of Kragujevac, Serbia

3Institute of Nuclear Sciences Vinca, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, Serbia

4Faculty of Stomatology in Pancevo, University Business Academy, Serbia


Congenital adrenal hyperplasia (CAH) is a rare autosomal recessive disorder with mutations in genes involved in cortisol and aldosterone production. Based on overall 21-OHase activity, CAH is divided into classic (C-CAH) and non-classic (NC-CAH). Females who suffered from NC-CAH have had increased infertility rates and higher miscarriage susceptibility. The treatment of CAH in pregnancy is still debatable.

We present 22 years old pregnant female (seventh week of gestation), who is currently under dexamethasone (DEX) since almost seven years for NC-CAH. At presentation, she is normotensive, non-obese, with no signs of hirsutism and Cushing syndrome. Seven days after the first visit, an endocrinologist makes informative talk with the patient and her mother about NC-CAH, pregnancy, and drugs-associated risks. Current Clinical Practice Guideline for CAH treatment suggests the use of protocols approved by Institutional Review Boards at Centers experienced in CAH treatment.

In women with CAH who are planning a pregnancy, a close relationship between endocrinologist, reproductive gynaecologist and molecular biologist is of great interest. Prenatal management with DEX is advised in particular circumstances. In remaining, the switch from DEX to other glucocorticoids that do not penetrate placenta is advised.